Characteristics of imported malaria cases in Hubei Province from 2016 to 2020

doi:10.12140/j.issn.1000-7423.2021.05.004

Abstract

Abstract:

Objective To analyze the characteristics of imported malaria cases in Hubei Province from 2016 to 2020 to provide scientific basis for optimizing the control strategies for post-elimination phase. Methods The data of reported malaria cases in Hubei Province during 2016—2020 were collected from the National Infectious Disease Surveillance Reporting and Management System to analyze Plasmodium species, infection source, three compartment distribution and the experience of seeking medical care. The χ² test was applied for comparison of the correctness rate of initial diagnosis among different medical institutions. Results A total of 560 malaria cases were reported in Hubei Province during 2016—2020, all of them were imported from abroad. In total, 387 cases were infected with P. falciparum (69.11%), 75 with P. vivax (13.39%), 80 with P. ovale (14.29%), 16 with P. malariae (2.86%) and 2 with mixed infection (0.36%). The number of malaria cases reported by year in Hubei Province was 151, 96, 127, 151 and 35 in 2016—2020, respectively, among them the number reported in 2020 decreased by 76.82% compared to 2019. All the reported cases were imported from 39 countries in four continents. The top five countries with the highest imported number were the Democratic Republic of the Congo (117), Nigeria (49), Ethiopia (48), Angola (45) and the Republic of Congo (32). During this period, malaria cases were reported all year round, with the reporting peak in January (77), February (76) and November (51). Malaria cased were reported from all 16 cities (prefecture) except Shennongjia Forestry District, mainly from Wuhan (184), Yichang (81), Huangshi (56), Xiangyang (39), and Shiyan (36). Among all cases, 85.36% (478/560) occurred in the age group 20-49; 540 cases were in males and 20 in females, with a gender ratio of 27 : 1. Most of the malaria cases (361, 64.47%) visited doctor 2 days after outset of disease, but 69 cases (12.32%) consulted doctor over 11 days after outset. Overall, 396 cases were diagnosed as malaria, with a correctness rate of diagnosis 70.71% at the initial visit. Of the reported cases, 410 sought initial visit in county-based medical institutions or higher settings (410/560, 73.21%), and the correctness rate of diagnosis was 77.32% (317/410); The numbers of cases seeking initial visit to town health center, individual doctor or village clinic were 45, 16 and 27, respectively, with the correctness rate of diagnosis of 40.00% (18/45), 1/16, and 11.11% (3/27), respectively. The correctness rate of diagnosis was significantly different among different medical institutions (χ² = 103.744, P < 0.05). In addition, 55.89% (313/560) of the cases were diagnosed as malaria within 24 hours; 26.43% (148/560) of the cases spent more than 4 days of time span from initial visit to confirmed diagnosis. Most of the cases (80.89%, 453/560) were diagnosed as malaria in medical institutions. Two death cases of imported falciparum malaria were reported in the province during 2016—2020. Conclusion During 2016—2020, all reported cases in Hubei Province were imported cases, and most of them were caused by P. falciparum. The cases were mainly distributed in Wuhan City, in males and in the age group of 20-49 years. The majority cases sought health consultation in medical institutions, and the correctness rate of diagnosis upon the initial visit was higher in county-based medical institutions or settings at higher level.

Key words: Malaria, Imported case, Epidemic characteristics, Hubei Province

CLC Number:

R531.3

WU Dong-ni, ZHANG Hua-xun, ZHU Hong, WAN Lun, ZHANG Juan, SUN Ling-cong, DONG Xiao-rong, YI Jia, CAO Mu-min, XIA Jing. Characteristics of imported malaria cases in Hubei Province from 2016 to 2020[J]. CHINESE JOURNAL OF PARASITOLOGY AND PARASITIC DISEASES, 2021, 39(5): 585-591.

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地区 District	虫种分型 Plasmodium species					合计 Total	占比/%Percentage/%
地区 District	恶性疟原虫 P. falciparum	间日疟原虫 P. vivax	卵型疟原虫 P. ovale	三日疟原虫 P. malariae	混合感染 Mixed infection	合计 Total	占比/%Percentage/%
非洲 Africa
刚果（金） Democratic Republic of the Congo	101	0	13	3	0	117	20.89
尼日利亚 Nigeria	40	0	9	0	0	49	8.75
安哥拉 Angola	3	43	1	0	1	48	8.57
埃塞俄比亚 Ethiopia	33	0	8	4	0	45	8.04
刚果（布） Republic of Congo	23	1	6	1	1	32	5.71
其他26个国家 Other 26 countries	186	5	42	7	0	240	42.86
亚洲 Asia
巴基斯坦 Pakistan	0	16	0	0	0	16	2.86
印度尼西亚 Indonesia	0	5	0	0	0	5	0.89
其他4个国家 Other 4 countries	0	3	1	0	0	4	0.71
南美洲 South America
圭亚那 Guyana	1	1	0	0	0	2	0.36
大洋洲 Oceania
巴布亚新几内亚 Papua New Guinea	0	1	0	1	0	2	0.36
合计 Total	387	75	80	16	2	560	100

年份Year	报告总病例数 Total no. case reported	< 24 h		1~2 d		3~4 d		5~10 d		≥ 11 d
年份Year	报告总病例数 Total no. case reported	病例数 No. case	构成比/% Constituent/%	病例数 No. case	构成比/% Constituent/%	病例数 No. case	构成比/% Constituent/%	病例数 No. case	构成比/% Constituent/%	病例数 No. case	构成比/% Constituent/%
2016	151	10	6.62	79	52.32	27	17.88	18	11.92	17	11.26
2017	96	31	32.29	22	22.92	11	11.46	10	10.42	22	22.92
2018	127	35	27.56	39	30.71	14	11.02	12	9.45	27	21.26
2019	151	63	41.72	58	38.41	19	12.58	8	5.30	3	1.99
2020	35	11	31.43	13	37.14	8	22.86	3	8.57	0	0
合计Total	560	150	26.79	211	37.68	79	14.11	51	9.11	69	12.32

初诊单位 Initial diagnosis unit	报告病例数 No. case reported	构成比/% Constituent/%	初诊确诊为疟疾病例数 No. case of malaria diagnosed initial	确诊率/% Correctness rate of diagnosis/%
省级疾控机构 Provincial CDC	0	0	-	-
地市级疾控机构 Municipal CDC	16	2.86	16	16/16
县级疾控机构 County CDC	35	6.25	34	97.14
省级医疗机构 Provincial hospital	58	10.36	43	74.14
地市级医疗机构 Municipal hospital	207	36.96	168	81.16
县级医疗机构 County hospital	145	25.89	106	73.10
乡镇卫生院 Town clinic	45	8.04	18	40.00
个体医生 Individual doctor	16	2.86	1	1/16
村卫生室 Village clinic	27	4.82	3	11.11
检验检疫机构 Inspection and quarantine authority	6	1.07	6	6/6
其他 Other	5	0.89	1	1/5
合计Total	560	100	396	70.71

年份Year	≤ 24 h		2~3 d		≥ 4 d
年份Year	病例数 No. case	构成比/% Constituent/%	病例数 No. case	构成比/% Constituent/%	病例数 No. case	构成比/% Constituent/%
2016	82	54.30	28	18.54	41	27.15
2017	44	45.83	14	14.58	38	39.58
2018	56	44.09	28	22.05	43	33.86
2019	106	70.20	24	15.89	21	13.91
2020	25	71.43	5	14.29	5	14.29
合计Total	313	55.89	99	17.68	148	26.43